Application effect of fast track surgery for patients with esophageal cancer: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Jingjing ¹ , LU Jiaju ¹ , SHI Jiang ¹ , LIN Qingling ² , GUO Hong ² , TIAN Jinhui ³ ,  LIU Jian ² , YANG Kehu ³

1. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P.R.China;
2. Department of ICU, The First Hospital of Lanzhou University, Lanzhou, 730000, P.R.China;
3. Evidence-based Medicine Center, Lanzhou University, Lanzhou, 730000, P.R.China;

Corresponding author：

LIU Jian, Email: medecinliu@sina.com

Keywords：

Esophageal cancer; fast track surgery; perioperative period; systematic review

DOI：

10.7507/1007-4848.201707005

Video：

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Objective To evaluate the effect of fast track surgery (FTS) after esophageal cancer surgery. Methods The randomized controlled trial (RCT) and observational studies about FTS for esophageal cancer in PubMed、EMbase、The Cochrane Library、Web of Science、CBM、CNKI and WanFang databases were searched up to May 2017. Then the studies were screened according to the inclusion and exclusion criteria by two researchers. Data were analyzed by Stata12.0 software. Results Totally 13 RCTs and 5 observational studies with 2 447 patients were eligible for analysis. Compared with the control group, incidence of postoperative complications (OR=0.53, 95%CI 0.40 to 0.71, P<0.05) significantly reduced in the FTS group, but there was no significant difference between the two groups in readmission rate (OR=1.21, 95%CI 0.83 to 1.76, P=0.313) and 30 d mortality rate (OR=0.72, 95%CI 0.43 to 1.20, P=0.207). Conclusion FTS can safely and effectively accelerate the recovery of patients with esophageal cancer and it owns important clinical values.

Citation： LIU Jingjing, LU Jiaju, SHI Jiang, LIN Qingling, GUO Hong, TIAN Jinhui, LIU Jian, YANG Kehu. Application effect of fast track surgery for patients with esophageal cancer: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(7): 596-603. doi: 10.7507/1007-4848.201707005 Copy

1.	Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
2.	Gustafsson UO, Scott MJ, Schwenk W, et al. Enhanced Recovery After Surgery (ERAS) Society. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr, 2012, 31(6): 783-800.
3.	Nygren J, Thacker J, Carli F, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr, 2012, 31(6): 801-816.
4.	Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr, 2012, 31(6): 817-830.
5.	China Enhanced Recovery After Surgery Group of Chinese Society for Parenteral and Enteral Nutrition. Chinese consensus of enhanced recovery after surgery for colorectal surgery (2015). Zhonghua Wei Chang Wai Ke Za Zhi, 2015, 18(8): 785-787.
6.	Zhao JH, Sun JX, Huang XZ, et al. Meta-analysis of the laparoscopic versus open colorectal surgery within fast track surgery. Int J Colorectal Dis, 2016, 31(3): 613-622.
7.	马永恒, 王满才, 高天明. 快速康复外科应用于食管癌的安全性和可行性的 Meta 分析及系统评价. 卫生职业教育, 2013, 31(3): 146-151.
8.	Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
9.	周洪伟, 范涛, 胡浩, 等. 快速康复外科在食管癌外科治疗中的应用价值. 临床外科杂志, 2014, 22(9): 703-704.
10.	赵桂彬, 曹守强, 张凯,等. 快速康复外科对食管癌手术患者胰岛素抵抗指标的影响. 中华临床营养杂志, 2012, 20(2): 78-83.
11.	陈雷. 围手术期护理干预对食管癌手术预后的影响. 当代医学, 2016, 22(16): 85-86.
12.	陈正平, 张绍岚, 杨留才. 快速康复外科在食管癌外科手术中的应用. 科技通报, 2012, 28(8): 22-25.
13.	Sato H, Tsubosa Y. pp058-mon An enhanced recovery after surgery program in patients who have undergone thoracic esophageal cancer surgery reduces infectious complications. Clin Nutr, 2012, 7(1): 160-161.
14.	Wang JY, Hong X, Chen GH, et al. Clinical application of the fast track surgery model based on preoperative nutritional risk screening in patients with esophageal cancer. Asia Pac J Clin Nutr, 2015, 24(2): 206-211.
15.	钱军. 应用快速康复外科治疗食管癌患者的安全性及有效性分析. 实用临床医药杂志, 2014, 18(23): 86-87.
16.	Tang J, Humes DJ, Gemmil E, et al. Reduction in length of stay for patients undergoing oesophageal and gastric resections with implementation of enhanced recovery packages. Ann R Coll Surg Engl, 2013, 95(5): 323-328.
17.	刘瑞. 食管癌围手术期应用快速康复外科护理的效果观察. 临床医药文献电子杂志, 2016, 3(52): 10382.
18.	林小芳, 黄先玲, 钟番番, 等. 快速康复外科理念在食管癌患者围术期中的应用. 齐鲁护理杂志, 2014, 20(10): 43-44.
19.	Shewale JB, Correa AM, Baker CM, et al. Impact of a fast-track esophagectomy protocol on esophageal cancer patient outcomes and hospital charges. Ann Surg, 2015, 261(6): 1114-1123.
20.	李熠, 罗萍, 李哲, 等. 快速康复外科护理在食管癌患者围手术期中应用效果. 国际医药卫生导报, 2015, 21(17): 2641-2643.
21.	公丕欣, 李春华, 阴其玲, 等. 加速康复外科在食管癌围手术期中的护理应用. 泰山医学院学报, 2016, 37(2): 155-157.
22.	Karran A, Wheat J, Chan D, et al. Propensity score analysis of an enhanced recovery programme in upper gastrointestinal cancer surgery. World J Surg, 2016, 40(7): 1645-1654.
23.	杨秀梅, 梁东云, 普春梅. 快速康复外科理念在食管癌围手术期护理中的应用. 当代护士, 2015, 13(6): 56-57.
24.	冯桂荣, 李丽华. 快速康复外科理念在食管癌患者围术期护理中的应用. 护理实践与研究, 2013, 10(15): 44-45.
25.	丁玮. 快速康复理念在胸腹腔镜联合食管癌根治术围手术期护理中的应用. 医药与保健, 2014, 22(10): 124-125.
26.	Cao S, Zhao G, Cui J, et al. Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study. Support Care Cancer, 2013, 21(3): 707-714.

1. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
2. Gustafsson UO, Scott MJ, Schwenk W, et al. Enhanced Recovery After Surgery (ERAS) Society. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr, 2012, 31(6): 783-800.
3. Nygren J, Thacker J, Carli F, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr, 2012, 31(6): 801-816.
4. Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr, 2012, 31(6): 817-830.
5. China Enhanced Recovery After Surgery Group of Chinese Society for Parenteral and Enteral Nutrition. Chinese consensus of enhanced recovery after surgery for colorectal surgery (2015). Zhonghua Wei Chang Wai Ke Za Zhi, 2015, 18(8): 785-787.
6. Zhao JH, Sun JX, Huang XZ, et al. Meta-analysis of the laparoscopic versus open colorectal surgery within fast track surgery. Int J Colorectal Dis, 2016, 31(3): 613-622.
7. 马永恒, 王满才, 高天明. 快速康复外科应用于食管癌的安全性和可行性的 Meta 分析及系统评价. 卫生职业教育, 2013, 31(3): 146-151.
8. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
9. 周洪伟, 范涛, 胡浩, 等. 快速康复外科在食管癌外科治疗中的应用价值. 临床外科杂志, 2014, 22(9): 703-704.
10. 赵桂彬, 曹守强, 张凯,等. 快速康复外科对食管癌手术患者胰岛素抵抗指标的影响. 中华临床营养杂志, 2012, 20(2): 78-83.
11. 陈雷. 围手术期护理干预对食管癌手术预后的影响. 当代医学, 2016, 22(16): 85-86.
12. 陈正平, 张绍岚, 杨留才. 快速康复外科在食管癌外科手术中的应用. 科技通报, 2012, 28(8): 22-25.
13. Sato H, Tsubosa Y. pp058-mon An enhanced recovery after surgery program in patients who have undergone thoracic esophageal cancer surgery reduces infectious complications. Clin Nutr, 2012, 7(1): 160-161.
14. Wang JY, Hong X, Chen GH, et al. Clinical application of the fast track surgery model based on preoperative nutritional risk screening in patients with esophageal cancer. Asia Pac J Clin Nutr, 2015, 24(2): 206-211.
15. 钱军. 应用快速康复外科治疗食管癌患者的安全性及有效性分析. 实用临床医药杂志, 2014, 18(23): 86-87.
16. Tang J, Humes DJ, Gemmil E, et al. Reduction in length of stay for patients undergoing oesophageal and gastric resections with implementation of enhanced recovery packages. Ann R Coll Surg Engl, 2013, 95(5): 323-328.
17. 刘瑞. 食管癌围手术期应用快速康复外科护理的效果观察. 临床医药文献电子杂志, 2016, 3(52): 10382.
18. 林小芳, 黄先玲, 钟番番, 等. 快速康复外科理念在食管癌患者围术期中的应用. 齐鲁护理杂志, 2014, 20(10): 43-44.
19. Shewale JB, Correa AM, Baker CM, et al. Impact of a fast-track esophagectomy protocol on esophageal cancer patient outcomes and hospital charges. Ann Surg, 2015, 261(6): 1114-1123.
20. 李熠, 罗萍, 李哲, 等. 快速康复外科护理在食管癌患者围手术期中应用效果. 国际医药卫生导报, 2015, 21(17): 2641-2643.
21. 公丕欣, 李春华, 阴其玲, 等. 加速康复外科在食管癌围手术期中的护理应用. 泰山医学院学报, 2016, 37(2): 155-157.
22. Karran A, Wheat J, Chan D, et al. Propensity score analysis of an enhanced recovery programme in upper gastrointestinal cancer surgery. World J Surg, 2016, 40(7): 1645-1654.
23. 杨秀梅, 梁东云, 普春梅. 快速康复外科理念在食管癌围手术期护理中的应用. 当代护士, 2015, 13(6): 56-57.
24. 冯桂荣, 李丽华. 快速康复外科理念在食管癌患者围术期护理中的应用. 护理实践与研究, 2013, 10(15): 44-45.
25. 丁玮. 快速康复理念在胸腹腔镜联合食管癌根治术围手术期护理中的应用. 医药与保健, 2014, 22(10): 124-125.
26. Cao S, Zhao G, Cui J, et al. Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study. Support Care Cancer, 2013, 21(3): 707-714.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application effect of fast track surgery for patients with esophageal cancer: A systematic review and meta-analysis

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